1. Barrett B, Mosweu I, Jones CR, Charman T, Baird G, Simonoff E, Pickles A, Happe F, Byford S. {{Comparing service use and costs among adolescents with autism spectrum disorders, special needs and typical development}}. {Autism};2014 (Jun 9)
Autism spectrum disorder is a complex condition that requires specialised care. Knowledge of the costs of autism spectrum disorder, especially in comparison with other conditions, may be useful to galvanise policymakers and leverage investment in education and intervention to mitigate aspects of autism spectrum disorder that negatively impact individuals with the disorder and their families. This article describes the services and associated costs for four groups of individuals: adolescents with autistic disorder, adolescents with other autism spectrum disorders, adolescents with other special educational needs and typically developing adolescents using data from a large, well-characterised cohort assessed as part of the UK Special Needs and Autism Project at the age of 12 years. Average total costs per participant over 6 months were highest in the autistic disorder group ( pound11,029), followed by the special educational needs group ( pound9268), the broader autism spectrum disorder group ( pound8968) and the typically developing group ( pound2954). Specialised day or residential schooling accounted for the vast majority of costs. In regression analysis, lower age and lower adaptive functioning were associated with higher costs in the groups with an autism spectrum disorder. Sex, ethnicity, number of International Classification of Diseases (10th revision) symptoms, autism spectrum disorder symptom scores and levels of mental health difficulties were not associated with cost.
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2. Brugha TS, McManus S, Bankart J, Jenkins R, Smith J, Scott F. {{The proportion of true cases of autism is not changing}}. {BMJ};2014;348:g3774.
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3. DeVilbiss EA, Lee BK. {{Brief Report: Trends in U.S. National Autism Awareness from 2004 to 2014: The Impact of National Autism Awareness Month}}. {J Autism Dev Disord};2014 (Jun 11)
We sought to evaluate the potential for using historical web search data on autism spectrum disorders (ASD)-related topics as an indicator of ASD awareness. Analysis of Google Trend data suggested that National Autism Awareness Month and televised reports concerning autism are an effective method of promoting online search interest in autism.
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4. Garcia-Primo P, Hellendoorn A, Charman T, Roeyers H, Dereu M, Roge B, Baduel S, Muratori F, Narzisi A, Van Daalen E, Moilanen I, de la Paz MP, Canal-Bedia R. {{Screening for autism spectrum disorders: state of the art in Europe}}. {Eur Child Adolesc Psychiatry};2014 (Jun 10)
A large number of studies have reported on the validity of autism spectrum disorder (ASD) screening procedures. An overall understanding of these studies’ findings cannot be based solely on the level of internal validity of each, since screening instruments might perform differently according to certain factors in different settings. Europe has led the field with the development of the first screening tool and first prospective screening study of autism. This paper seeks to provide an overview of ASD screening studies and ongoing programmes across Europe, and identify variables that have influenced the outcomes of such studies. Results show that, to date, over 70,000 children have been screened in Europe using 18 different screening procedures. Differences among findings across studies have enabled us to identify ten factors that may influence screening results. Although it is impossible to draw firm conclusions as to which screening procedure is most effective, this analysis might facilitate the choice of a screening method that best fits a specific scenario, and this, in turn, may eventually improve early ASD detection procedures.
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5. Gray KM, Keating CM, Taffe JR, Brereton AV, Einfeld SL, Reardon TC, Tonge BJ. {{Adult Outcomes in Autism: Community Inclusion and Living Skills}}. {J Autism Dev Disord};2014 (Jun 11)
Longitudinal research has demonstrated that social outcomes for adults with autism are restricted, particularly in terms of employment and living arrangements. However, understanding of individual and environmental factors that influence these outcomes is far from complete. This longitudinal study followed a community sample of children and adolescents with autism into adulthood. Social outcomes in relation to community inclusion and living skills were examined, including the predictive role of a range of individual factors and the environment (socio-economic disadvantage). Overall, the degree of community inclusion and living skills was restricted for the majority, and while childhood IQ was an important determinant of these outcomes, it was not the sole predictor. The implications of these findings in relation to interventions are discussed.
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6. Jeste SS, Wu JY, Senturk D, Varcin K, Ko J, McCarthy B, Shimizu C, Dies K, Vogel-Farley V, Sahin M, Nelson CA, 3rd. {{Early developmental trajectories associated with ASD in infants with tuberous sclerosis complex}}. {Neurology};2014 (Jun 11)
OBJECTIVE: We performed a longitudinal cohort study of infants with tuberous sclerosis complex (TSC), with the overarching goal of defining early clinical, behavioral, and biological markers of autism spectrum disorder (ASD) in this high-risk population.METHODS: Infants with TSC and typically developing controls were recruited as early as 3 months of age and followed longitudinally until 36 months of age. Data gathered at each time point included detailed seizure history, developmental testing using the Mullen Scales of Early Learning, and social-communication assessments using the Autism Observation Scale for Infants. At 18 to 36 months, a diagnostic evaluation for ASD was performed using the Autism Diagnostic Observation Schedule.RESULTS: Infants with TSC demonstrated delays confined to nonverbal abilities, particularly in the visual domain, which then generalized to more global delays by age 9 months. Twenty-two of 40 infants with TSC were diagnosed with ASD. Both 12-month cognitive ability and developmental trajectories over the second and third years of life differentiated the groups. By 12 months of age, the ASD group demonstrated significantly greater cognitive delays and a significant decline in nonverbal IQ from 12 to 36 months.CONCLUSIONS: This prospective study characterizes early developmental markers of ASD in infants with TSC. The early delay in visual reception and fine motor ability in the TSC group as a whole, coupled with the decline in nonverbal ability in infants diagnosed with ASD, suggests a domain-specific pathway to ASD that can inform more targeted interventions for these high-risk infants.
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7. Jones L, Goddard L, Hill EL, Henry LA, Crane L. {{Experiences of Receiving a Diagnosis of Autism Spectrum Disorder: A Survey of Adults in the United Kingdom}}. {J Autism Dev Disord};2014 (Jun 11)
A total of 128 adults with high-functioning autism spectrum disorders were surveyed concerning the process they went through to obtain their diagnosis and the subsequent support they received. Results suggested that routes to diagnosis were quite heterogeneous and overall levels of satisfaction with the diagnostic process were mixed; 40 % of respondents were ‘very/quite’ dissatisfied, whilst 47 % were ‘very/quite’ satisfied. The extent of delays, number of professionals seen, quality of information given at diagnosis and levels of post-diagnostic support predicted overall satisfaction with the diagnostic process. Important areas and suggestions for improvement were noted for all stages of the diagnostic pathway. Respondents also displayed above average levels of depressed mood and anxiety, with greater support being requested in this area.
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8. Levey EJ. {{Effective Treatment Strategies for Autism During the First Five Years of Development}}. {J Am Psychoanal Assoc};2014 (Jun 9)
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9. Losh M, Gordon PC. {{Quantifying Narrative Ability in Autism Spectrum Disorder: A Computational Linguistic Analysis of Narrative Coherence}}. {J Autism Dev Disord};2014 (Jun 11)
Autism is a neurodevelopmental disorder characterized by serious difficulties with the social use of language, along with impaired social functioning and ritualistic/repetitive behaviors (American Psychiatric Association in Diagnostic and statistical manual of mental disorders: DSM-5, 5th edn. American Psychiatric Association, Arlington, 2013). While substantial heterogeneity exists in symptom expression, impairments in language discourse skills, including narrative (or storytelling), are universally observed in autism (Tager-Flusberg et al. in Handbook on autism and pervasive developmental disorders, 3rd edn. Wiley, New York, pp 335-364, 2005). This study applied a computational linguistic tool, Latent Semantic Analysis (LSA), to objectively characterize narrative performance in high-functioning individuals with autism and typically-developing controls, across two different narrative contexts that differ in the interpersonal and cognitive demands placed on the narrator. Results indicated that high-functioning individuals with autism produced narratives comparable in semantic content to those produced by controls when narrating from a picture book, but produced narratives diminished in semantic quality in a more demanding narrative recall task. This pattern is similar to that detected from analyses of hand-coded picture book narratives in prior research, and extends findings to an additional narrative context that proves particularly challenging for individuals with autism. Results are discussed in terms of the utility of LSA as a quantitative, objective, and efficient measure of narrative ability.
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10. Lozier LM, Vanmeter JW, Marsh AA. {{Impairments in facial affect recognition associated with autism spectrum disorders: A meta-analysis}}. {Dev Psychopathol};2014 (Jun 10):1-13.
Autism spectrum disorders (ASDs) are characterized by social impairments, including inappropriate responses to affective stimuli and nonverbal cues, which may extend to poor face-emotion recognition. However, the results of empirical studies of face-emotion recognition in individuals with ASD have yielded inconsistent findings that occlude understanding the role of face-emotion recognition deficits in the development of ASD. The goal of this meta-analysis was to address three as-yet unanswered questions. Are ASDs associated with consistent face-emotion recognition deficits? Do deficits generalize across multiple emotional expressions or are they limited to specific emotions? Do age or cognitive intelligence affect the magnitude of identified deficits? The results indicate that ASDs are associated with face-emotion recognition deficits across multiple expressions and that the magnitude of these deficits increases with age and cannot be accounted for by intelligence. These findings suggest that, whereas neurodevelopmental processes and social experience produce improvements in general face-emotion recognition abilities over time during typical development, children with ASD may experience disruptions in these processes, which suggested distributed functional impairment in the neural architecture that subserves face-emotion processing, an effect with downstream developmental consequences.
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11. Poslawsky IE, Naber FB, Bakermans-Kranenburg MJ, van Daalen E, van Engeland H, van IMH. {{Video-feedback Intervention to promote Positive Parenting adapted to Autism (VIPP-AUTI): A randomized controlled trial}}. {Autism};2014 (Jun 11)
In a randomized controlled trial, we evaluated the early intervention program Video-feedback Intervention to promote Positive Parenting adapted to Autism (VIPP-AUTI) with 78 primary caregivers and their child (16-61 months) with Autism Spectrum Disorder. VIPP-AUTI is a brief attachment-based intervention program, focusing on improving parent-child interaction and reducing the child’s individual Autism Spectrum Disorder-related symptomatology in five home visits. VIPP-AUTI, as compared with usual care, demonstrated efficacy in reducing parental intrusiveness. Moreover, parents who received VIPP-AUTI showed increased feelings of self-efficacy in child rearing. No significant group differences were found on other aspects of parent-child interaction or on child play behavior. At 3-months follow-up, intervention effects were found on child-initiated joint attention skills, not mediated by intervention effects on parenting. Implementation of VIPP-AUTI in clinical practice is facilitated by the use of a detailed manual and a relatively brief training of interveners.
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12. Szczesna K, de la Caridad O, Petazzi P, Soler M, Roa L, Saez MA, Fourcade S, Pujol A, Artuch-Iriberri R, Molero-Luis M, Vidal A, Huertas D, Esteller M. {{Improvement of the Rett Syndrome Phenotype in a Mecp2 Mouse Model Upon Treatment with Levodopa and a Dopa Decarboxylase Inhibitor}}. {Neuropsychopharmacology};2014 (Jun 11)
Rett Syndrome is a neurodevelopmental autism spectrum disorder caused by mutations in the gene coding for methyl CpG-binding protein (MeCP2). The disease is characterized by abnormal motor, respiratory, cognitive impairment, and autistic-like behaviors. No effective treatment of the disorder is available. Mecp2 knockout mice have a range of physiological and neurological abnormalities that resemble the human syndrome and can be used as a model to interrogate new therapies. Herein, we show that the combined administration of Levodopa and a Dopa decarboxylase inhibitor in Rett syndrome mouse models is well tolerated, diminishes Rett syndrome-associated symptoms and increases lifespan. The amelioration of Rett syndrome symptomatology is particularly significant in those features controlled by the dopaminergic pathway in the nigrostratium, such as mobility, tremor and breathing. Most important, the improvement of the Rett syndrome phenotype upon use of the combined treatment is reflected at the cellular level by the development of neuronal dendritic growth. However, much work is required to extend the duration of the benefit of the described preclinical treatment.Neuropsychopharmacology accepted article preview online, 11 June 2014; doi:10.1038/npp.2014.136.
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13. Takagaki K, Russell J, Lippert MT, Motamedi GK. {{Development of the posterior basic rhythm in children with autism}}. {Clin Neurophysiol};2014 (May 27)
OBJECTIVE: Early detection of autism is critical for effective intervention, but currently, no simple screening tests are available. Furthermore, little is known about the development of brain dynamics in young children. We examine the early neurophysiological manifestations of autism by retrospectively analyzing EEG. In particular, we focus on maturation of the posterior basic rhythm (PBR), which is one of the most characteristic features of the normal EEG, and comprises a discrete functional state. METHODS: Subjects with a diagnosis of autism (n=74), as well as normal (n=134) and epileptic (n=108) controls, were extracted retrospectively from our digital EEG database. Segments with clear PBR were extracted, and standard signal analysis methods were used to calculate peak PBR frequency, power, and coherence. RESULTS: In our cohort, a subset of autistic children show accelerated development of the PBR, with early maturation especially in the 2- to 4-year old range. The overall coherence of PBR-specific activity is also lower in autistic children in our cohort. CONCLUSIONS: These findings provide evidence that autism is associated with accelerated development of the PBR. SIGNIFICANCE: These findings generate a clinical hypothesis for future prospective studies on the efficacy of these simple measures as a diagnostic or screening tool.
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14. Zoder-Martell KA, Dufrene BA, Tingstrom DH, Olmi DJ, Jordan SS, Biskie EM, Sherman JC. {{Training direct care staff to increase positive interactions with individuals with developmental disabilities}}. {Res Dev Disabil};2014 (Jun 7);35(9):2180-2189.
This study tested the effects of direct training on direct care staff’s initiation of positive interactions with individuals with developmental disabilities who resided in an intermediate care facility. Participants included four direct care staff and their residents. Direct training included real-time prompts delivered via a one-way radio, and data were collected for immediate and sustained increases in rates of direct care staff’s positive interactions. Additionally, this study evaluated the link between increased rates of positive interactions and concomitant decreases in residents’ challenging behaviors. A multiple baseline design across participants was used and results indicated that all direct care staff increased their rates of positive interactions during direct training. Moreover, all but one participant continued to engage residents in positive interactions at levels above the criterion during the maintenance phase and follow-up phases. The direct care staff member who did not initially meet the criterion improved to adequate levels following one brief performance feedback session. With regard to residents’ challenging behaviors, across phases, residents engaged in low levels of challenging behaviors making those results difficult to evaluate. However, improvements in residents’ rate of positive interactions were noted.
